THANK YOU!

Let us discuss the distance between where you are and where you want to be, and all the ways you can bridge that gap starting now. Together we'll design 1 or 2 simple actions or habits that will bring you closer to your ideal health and life. Experience better digestion, all-day energy, more focus, and more... after just one conversation.

Living healthy doesn't have to be hard. Let me show you how.

As a Licensed Psychotherapist, MA LLP and Holistic Health Coach, AADP based in Michigan, I'm on a mission to spread the word that being a mom, parent, or professional doesn't mean you can't be your best YOU, too. Book your consultation.

Once upon a time, I took the bait, too. I bought every health book out there, watched all the shows and spent hours on the Internet researching the right foods to eat. What I discovered is that there IS no “right” food! We are all different and have unique nutritional needs. With a focus on intuitive education and holistic living, I'll guide you to reclaim control of your radiance, vitality, and happiness in ways that are best for you. I’m here to help you listen to your body and create your most beautiful, balanced life. Are you ready?

Revisit Form

Revisit Form

All of your information will remain confidential between you and the Health Coach.

Name *

Name

First Name

Last Name

Email Address *

Health Information

What positive changes have you noticed since your last session?

What are your main concerns at this time?

Any changes with weight?

How is your sleep?

Constipation or diarrhea?

How is your mood?

Food Information

Are you cooking more?

What foods do you crave?

What is your diet like these days?

Breakfast

Lunch

Dinner

Snacks

Liquids

Additional Comments

Anything else you would like to share?

Thank you!

Men's Health

Men's Health

Personal Information

Name: *

Name:

First Name

Last Name

Email Address: *

How often do you check e-mail?

Home Phone

Home Phone

(###)

###

####

Work Phone

Work Phone

(###)

###

####

Mobile Phone

Mobile Phone

(###)

###

####

Age:

Height:

Date of Birth:

Date of Birth:

MM

DD

YYYY

Place of Birth:

Current weight:

Weight six weeks ago:

One year ago:

Would you like your weight to be different?

If so, what?

Social Information:

Relationship status:

Where do you currently live?

Children:

Pets:

Occupation:

Hours of work per week:

Health Information

Please list your main health concerns:

Other Concerns and/or goals?

At what point in your life did you feel best?An

Any serious illnesses/hospitalization/injuries?Ho

How is/was the health of your mother?

How is/was the health of your father?

What is your ancestry?

What blood type are you?

How is your sleep?

How many hours?

Do you wake up at night?

Why?

Any pain, stiffness or swelling?

Constipation/Diarrhea/Gas?

Allergies or sensitivities? Please explain:

Medical Information

Do you take any supplements or medication? Please list:

Any healers, helpers or therapies with which you are involved? Please list:

What role do sports and exercise play in your life?

Food Information

What foods did you eat often as a child?

Breakfast:

Lunch:

Dinner:

Snacks:

Liquids:

Will family and/or friends be supportive of your desire to make food and/or lifestyle changes?